Cerese Fegley-Killins
Summary
Medical Insurance Specialist with strong background building rapport with providers and patients. Committed to providing personalized service and quality patient care. Well-versed in healthcare practices, compliance standards and operations. Organized and dedicated with proven track record of providing exceptional patient care in fast-paced environments. Offering keen attention to detail and strong decision-making skills to manage multiple, concurrent tasks. Self-motivated work ethic to perform effectively in independent or team environments.
Overview
11
11
years of professional experience
Work History
Medical Referral Specialist
OakStreet Health
12.2023 - Current
- Communicated effectively with medical professionals at various levels within the organization to provide accurate information regarding patient needs and preferences during specialty consultations.
- Utilized electronic health record systems to track patient progress, facilitating effective follow-up care.
- Maintained comprehensive records of referrals, allowing for seamless communication between primary care physicians and specialists.
- Managed a high volume of referrals daily while consistently meeting deadlines for processing requests and scheduling appointments.
- Supported administrative staff in handling insurance authorizations, minimizing financial barriers to access specialty care.
Medical Office Coordinator
OrthoArizona
03.2021 - 12.2023
- Communicated with patients, insurance companies and providers through phone calls, emails and office drives concerning formularies and coverage limits.
- Provided exceptional customer service to patients, addressing concerns promptly and professionally.
- Created and maintained medical records from time of admission through patient discharge.
- Facilitated timely billing processes to ensure accurate and prompt reimbursement from insurance providers.
- Enhanced patient satisfaction by streamlining appointment scheduling and managing office communications.
Medical Office Manager
Community Psychological Services
03.2019 - 03.2021
- Maintained strict confidentiality of sensitive patient information, adhering to HIPAA guidelines and safeguarding against potential data breaches.
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable.
- Assisted physicians with clinical documentation to ensure complete and accurate records for each patient visit.
- Maintained up-to-date knowledge of healthcare regulations and policies, ensuring the practice remained in compliance at all times.
- Increased revenue by optimizing billing processes and ensuring timely collection of payments from both patients and insurance companies.
Medical Intake
BlueCross Blue Shield
07.2013 - 03.2019
- Collaborated effectively with various interdisciplinary teams, including medical, nursing, and administrative staff, to ensure seamless patient care delivery.
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in both outpatient and inpatient medical records.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
Education
High School Diploma -
Catasauqua Senior High School
Northampton, PASkills
- Health Insurance Management
- Medical Terminology
- HIPAA Compliance
- Patient Relations
- Medical office administration
- Medical billing and coding
- HCPCS Coding
- Insurance coding (ICD-9 and CPT)
- Clinical Documentation
- EMR / EHR
- Medical Records Management
- Payment collection and processing
Timeline
Medical Referral Specialist
OakStreet Health
12.2023 - Current
Medical Office Coordinator
OrthoArizona
03.2021 - 12.2023
Medical Office Manager
Community Psychological Services
03.2019 - 03.2021
Medical Intake
BlueCross Blue Shield
07.2013 - 03.2019
High School Diploma -
Catasauqua Senior High School
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